Work From Home Insurance Fraud Investigator Jobs

Bilingual Spanish Junior Healthcare Fraud Investigator:

Are you ready to launch your Healthcare Fraud Investigator career and make a real difference? If you're a recent college graduate eager to take the first step in your professional journey, this earlycareer opportunity is designed for you.This is a fantastic opportunity for someone with a Bachelors degree in Criminal Justice and is early in their career seeking to grow in a dynamic organization.

As a Junior Fraud Investigator for Cigna's Special Investigations Unit, you'll support our US Commercial Healthcare Business in conducting and supporting audits and investigations of potentially fraudulent claim activity by providers. You will bring investigative and analytics skills that include planning, developing and implementing investigative processes and procedures, along with making recommendations for potential corrective actions that include prosecution, recovery and/or litigation based on investigative findings.

What you'll do:

• Analyze information gathered by investigation/audit and report findings and prepare written summary/recommendations

• Prepare evidence package for referral to third parties including contract holders, state insurance fraud bureaus and law enforcement agencies

• Support on-site inspections and patient/provider interviews as necessary

• Respond to subpoenas and requests for information from law enforcement agencies and State Departments of Insurance. May represent company as a witness in judicial proceedings when appropriate

• Prepare reports to expedite tracking and reporting of investigations

Requirements:

• Located in South Florida (Miami, homestead) and West Palm Beach area to support site visits

• Bilingual Spanish

• A bachelor's degree in a Criminal Justice, or related field

• 1+ years professional work experience, preferably with health insurance investigations/audit

• Outstanding technical & analytical skills, with particular proficiency with Access, Excel and Word

• Excellent verbal and written communication skills, along with ability to effectively manage conflict

• Keen ability to deal with ambiguity and leverage reasoning skills

• Possession of a strong desire and demonstrated ability to lead

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

About The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.